What is a "Coordination of Care Recipient"?

Question: I received a result for a lab test ordered by another physician, though I had recently placed an order for the same test. Why did I receive this result?

Context: Since July 2024, Alberta Precision Labs (APL) has been able to electronically merge duplicative lab orders when a patient presents for collection, to avoid collecting separate specimens for each requisition. The results of the merged test are sent to all providers who ordered the test. However, since only one provider can be listed on the result as the Authorizing Provider, others who ordered the same test need to be listed on the result as something else, and also clearly distinguished from recipients designated as a "copy to" provider. The term "Coordination of Care Recipient" is therefore used for these additional ordering providers.

Answer: A Coordination of Care Recipient is an additional provider linked to a lab test order when multiple providers have requested the same test for a patient.

• When more than one provider orders the same test, the system merges these requests into one test at the time of collection.
• Because the system can only assign one Authorizing Provider, one provider remains listed as the Authorizing Provider, while all other providers become Coordination of Care Recipients.
• Both the Authorizing Provider and the Coordination of Care Recipients share equal responsibility for reviewing and acting on the test results, since they all ordered the test.

For more details, see:

• FAQ: Coordination of Care Recipients & Merging Duplicative Lab Requisitions

Why is there a delay in being able to view diagnostic images if the exam was completed at a Connect Care site?

Question: Why is there sometimes a delay between completion of an imaging investigation or intervention ordered in Connect Care and availability of associated images for viewing in Connect Care? 

Context: Diagnostic images are not instantly available to the ordering provider when an imaging exam is marked complete in Connect Care by a Technologist. The imaging workflow involves a number of steps that may not be apparent to all users:

1. A Technologist facilitating the intervention or investigation completes their documentation in Connect Care.
2. "Picture Archive and Communications System" (PACS) receives an "End Exam" message from Connect Care and generates a unique identifier for the exam.
3. The identifier initializes archiving of the diagnostic images and data to a storage system ("Impax Data Center", IDC).
4. IDC generates a message when all of the images for that diagnostic imaging procedure have been received, which then makes the images available to be viewed in Connect Care and Netcare.

Answer: A number of steps occur behind the scenes once an imaging investigation or intervention is marked complete in Connect Care by the performing Technologist. These steps are usually fast but can trigger a perceptible delay when a diagnostic imaging procedure generates many images, large images or image transfers when network traffic is high. These variables are outside of the control of the Technologist. 

If diagnostic images are taking longer than expected to appear for clinical use, or if the images are critical to provide urgent patient care, please call the IT Service Desk (1-877-311-4300) to report a high priority ticket, or email Imaging Apps Support (ImagingAppsSupport@ahs.ca; available Monday–Friday, 07:45–16:00). In critical situations, the images can be viewed in the imaging department if there is an unexpected delay with image transmission to Connect Care.

How can clinicians manage results released through the Patient Portal?

Question: Can prescribers attach comments to results that may help patients appreciate the personal significance of information released through MyChart?

Context: Most laboratory test results, diagnostic imaging reports and health intervention reports are released to MyChart, the Connect Care patient portal. Clinicians can use Hyperspace to detect whether a patient has MyChart enabled, is an active user, or has viewed specific results. It is also possible to attach comments to one or more test results or to manually withhold some results.

Answer: Connect Care offers some simple tools for recognizing when patients are active users of its patient portal and view results or reports. It is possible for physicians to comment on one or more results and to select specific results to withhold until further discussion has occurred.

• Tip: Managing Patient Portal Results & Comments
• Manual: Patient Messages

Can patients get COVID-19 test results through MyChart?

Question: Are COVID-19 test results (initial and confirmation) made available to patients through the patient portal (MyChart) and is result release delayed?

Answer:  The results of COVID-19 NAT testing (and later confirmation testing) are made available through MyChart with no delay. Encourage all patients to activate their patient portal account, as this method of results release can take pressure off of call centres. Physicians have the ability to manually override results release or to comment on results, just as with other test results.

Where are COVID-19 test results found?

Question: Where are COVID-19 NAT and confirmation results displayed within the Connect Care medical record?

Answer: COVID-19 test results are co-located with other respiratory pathogen test results in a "Microbiology" folder in the "Lab" tab of outpatient "Chart Review":

If in doubt, use the "Search" box with the keyword "COVID", as the NAT test classification has changed and some results may still appear under an "Other" category. For inpatients, respiratory viral studies, including COVID, do not appear in the Micro tab of chart "Summary". Instead, use Results Review or look in the "Lab" tab of chart "Summary" activity.

COVID-19 results also appear in Netcare outlines in the "Microbiology" folder. Netcare is the preferred resource for encounters that do not involve Connect Care. Netcare is a supplemental resource for Connect Care users and continues to be launchable from within Connect Care.

Is it okay for trainees to follow up on patient results after leaving a service?

Question: Residents and students can (and should) be copied on results associated with the orders they enter to the Connect Care clinical information system. Some orders do not get resulted until after the patient has left the hospital or the trainee has left the clinical service. Are we prohibited from accessing health information if not continuing as the patient's treatment physician?

Answer: Trainees may have concerns about a 2016 Alberta administrative law case (with clearer results on appeal); and the more recent Saskatchewan privacy commissioner reaction to ER physician access to charts of emergency patients that they had treated.

Health privacy legislation can differ in detail and interpretation from province to province. Alberta’s understanding of "circle of care" is not narrowly constrained by time or location alone. Need, role, purpose and accountability are important considerations.

For purposes of education (following up on a case), clinical feedback (seeing how one’s clinical decisions affected outcomes), quality control, practice audit and safety reviews, one remains in the circle of care "purpose". It can be important for authorized trainees to access, learn from, and possibly help improve results associated with the interventions they ordered in the care episode they participated in. Indeed, it could be argued that they should be particularly attentive to learning from their actions, as that was a key attribute of their role in the circle of care.

What is not okay is to access the record of a patient one has previously seen for a purpose unrelated to the specific care one participated in. For example, to explore other domains of care or types of information.

The Clinical Information Sharing Approach addresses questions like this.